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40 Cards in this Set
- Front
- Back
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Baseline Fetal Heart Rate
what controls FHR |
-the intrinsic rhythmicity of the fetal heart, the CNS, and ANS
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Baseline Fetal Heart Rate
what does an increase in the sympathetic response do to the FHR |
in acceleration of the FHR
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Baseline Fetal Heart Rate
what does an augmentation in the parasympathetic response do to the FHR |
a slowing of FHR
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Baseline Fetal Heart Rate
baseline fetal heart rate- normal range at term is |
- 110 to 160 beats/min
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Baseline Fetal Heart Rate
-variability of the FHR is: |
irregular fluctuations in the baseline FHR of 2 cycles per minute or greater
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Baseline Fetal Heart Rate
-diminished variability can result from (4) |
fetal hypoxia and acidosis, as well as drugs that suppress the CNS
-a temporary decrease can also occur when the fetus is in a sleep state |
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Baseline Fetal Heart Rate
-tachycardia is a baseline FHR greater than 160/beats min for a duration of 10 min or longer is considered an early signs of |
fetal hypoxemia
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Baseline Fetal Heart Rate
fetal tachycardia can result from maternal or fetal -4 |
infection,
prolonged rupture of membranes, maternal hyperthyroidism, response to drugs |
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Baseline Fetal Heart Rate
-bradycardia is an FHR baseline less than 110/beats per min for a duration of 10 min or longer is a late sign of |
fetal hypoxia and is known to occur before fetal death
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Baseline Fetal Heart Rate
-bradycardia is an FHR baseline less than 110/beats per min for a duration of 10 min or longer can result from -4 |
placental transfer of drugs, compression of umbilical cord, maternal hypothermia, maternal hypotension
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Changes in FHR
-categorized as periodic or episodic -peridodic: -episodic: |
-peridodic: those that occur with uterine contractions
-episodic: those that are not associated with uterine contractions |
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Intrauterine resuscitation-sometimes used to refer to those interventions initiated when a nonreassuring FHR pattern is noted
-what are they directed primarily toward improving? |
uterine blood flow, increasing maternal oxygenation and cardiac output
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Intrauterine resuscitation-sometimes used to refer to those interventions initiated when a nonreassuring FHR pattern is noted
-nurses have to assign priority interventions to maximize intrauterine resuscitation -what are the 3 priorites |
-1st priority is to open the maternal and fetal vascular systems
-2nd priority is to increase blood volume -3rd priority is to optimize oxygenation of circulating blood volume |
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-to relieve FHR deceleration, the nurse can do 3 things:
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-assist to side lying position
-increase maternal blood volume by increasing the rate of primary IV fusion or by raising the woman’s legs -provide oxygen by face mask |
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Amnioinfusion
-used during labor to do what 2 things: |
to supplement the amount of amniotic fluid to reduce the severity of decelerations caused by cord compression
or to dilute meconium-stained amniotic fluid |
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Amnioinfusion
supplement of amniotic fluid is indicated for clients with |
-oliogohydramnios small/absent amount of amniotic fluid)
without amniotic fluid, the umbilical cord can easily become compressed during contractions or fetal movement, diminishing blood flow to the fetus which is evidenced by variable decelerations |
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Amnioinfusion
-amnioinfusion replaces the “cushion” for the cord and relieves |
variable decelerations
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-what is indicated in the presence of moderate to think meconium?
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amnioinfusion
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-risk for amnioinfusion are:
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-overdistension of the uterine cavity
-increase uterine tone |
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Other methods of assessment and intervention
-umbilical cord acid-base determination is useful as an: |
adjunct to the Apgar score in assessing the immediate condition of the newborn
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Fetal heart rate response to stimulation
-stimulation of the fetus is done to elicit what? |
an acceleration of the FHR of 15 min/ber for at least 15 sec
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Fetal heart rate response to stimulation
-a FHR acceleration response usually indicates |
fetal well being
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Fetal heart rate response to stimulation
-2 stimulations |
-scalp stimulation (using digital pressure during a vaginal exam)
-vibroacoustic stimulation (using artificial larynx or fetal acoustic stimulation device over the fetal head for 1-2 sec) |
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Fetal oxygen saturation monitoring (fetal pulse oximetry –EPO)
-a specially designed sensor is inserted next to the fetal cheek or temple area to assess |
oxygen saturation
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Fetal oxygen saturation monitoring (fetal pulse oximetry –EPO)
-normal range of o2 saturation in the adult is -normal range for a healthy fetus is |
-normal range of o2 saturation in the adult is 95-100%
-normal range for a healthy fetus is 30-70% |
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Fetal scalp blood sampling is used to assess what 3 things
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fetal ph, PO2, and PCO2
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Changes in FHR
-accelerations can be periodic or episodic periodic are caused by what? what position are they seen with? |
-periodic: caused by dominance of the sympathetic nervous system
are seen with breech presentations |
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Changes in FHR
-accelerations can be periodic or episodic episodic occur during what? what do they indicate? |
-episodic: occur during fetal movement
indicate fetal well being |
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -early: gradual decrease in FHR and return to baseline in response to: |
fetal head compression (normal and benign finding) –
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable early: gradual decrease in FHR and return to baseline -when does it start? |
starts before the peak of the uterine contraction
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -late: gradual decrease in FHR and return to baseline, caused by |
uteroplacental insufficiency
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable late: gradual decrease in FHR and return to baseline -when does this begin in relationship to the contraction? |
-begins after the contraction has started
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -persistent and repetitive late decels is a sign of |
fetal hypoxemia
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -variable is an: |
abrupt decrease in FHR below the baseline
-decrease is 15 beats/min or more, lasts at least 15 sec, and returns to baseline in less than 2 min from the time of onset |
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -variable occurs when in relationship to the contraction? |
-may occur any time during the uterine contracting phase
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable variables are caused by |
cord compression of the umbilical
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -U, V, W shape |
variable
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable intervention for variable: |
-can usually be resolved by changing positions from 1 side to another
-oxygen via face mask can help too |
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Changes in FHR
-decelerations may be benign or nonreassuring: either early, late, variable -can result from decreased amniotic fluid or oligohydraminos |
variable
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Late decels
-caused by? -nadars? Prolonged decel -caused by? -nadars? |
Late decels –uretoplacental insufficiency –naders don’t match up
Prolonged decel (head squishing as it comes down) naders match up |
